The urethra, which is responsible for carrying semen and urine out of the penis, connects at the tip of the penis. This opening is known as the meatus. Hypospadias is caused when this opening is not at the tip of the penis, but rather in the wrong position somewhere along the underside of the penis. This is often accompanied by ill formed foreskin on the tip of the penis. Hypospadias is most often noticed at birth. In some cases, a boy may be born with hypospadias, which is a condition that causes the penis not only to be problematic functionally but also doesn't look normal. As a paediatric urologist, Dr Ridgard is able to assist in the correction of this condition with surgery known as a hypospadias repair.
How is hypospadias repair done?
This surgery is usually done within the first 2 years after birth, and the ultimate goal is to provide a penis that works well and looks as normal as possible. To do this, under general anaesthesia, Dr Ridgard will repair the urethra (urethroplasty) and create a new opening for the penis (meatoplasty/glanuloplasty), as well as straighten the penis shaft (orthoplasty). In some cases, repair of the scrotum (scrotoplasty) and skin grafting may be needed. There are many different approaches for a hypospadias repair, but the approach for treatment will depend on the individual as each case is unique.
These repairs can be done in one surgery; however, in some cases, it may require multiple surgeries. Your urologist will prefer to perform surgery when your baby is between 6 and 12 months old as this is when surgery causes the least discomfort, but surgery can be performed at any age.
Following the surgery the penis will be covered loosely with gauze and an antibacterial ointment will be applied. A catheter may be left in position for a few days after surgery to prevent urine from making contact with the wound. The catheter will then drain into the nappy. Dr Ridgard will instruct you prior to and after surgery on what you can expect and what recovery may involve. In some cases, a hypospadias surgery may require a follow-up surgery to adjust as the penis after it grows at puberty.